FROM CHILDHOOD TO ADULTHOOD METABOLIC SYNDROME SILENT THREAT (E-Kitap)

Metabolic syndrome (MetS) is a complex clinical picture in which a series of metabolic abnormalities that constitute a high risk for cardiovascular diseases, type 2 diabetes and various metabolic comorbidities coexist (1). This concept is accepted as an expression of a systemic deterioration in which various pathophysiological processes trigger each other. MetS is a clinical picture in which multiple metabolic disorders including hyperinsulinaemia, impaired glucose metabolism, low high-density lipoprotein cholesterol (HDL-C) levels and increased low-density lipoprotein cholesterol (LDL-C) and triglyceride concentrations, hypertension, systemic inflammation and thrombotic tendency are present together and cardiovascular risk is markedly increased (2). Although it was initially defined in adults, it has become an important public health problem in the paediatric age group with the prevalence of obesity and metabolic disorders in childhood and adolescence in recent years.Although it has been referred to by various names including Syndrome X, polymetabolic syndrome, fatal quartet, insulin resistance syndrome and civilisation syndrome in different periods in the literature, the term "MetS" has become established as a terminological standard (3,4).The incidence of MetS in childhood has increased alongside the global rise in obesity. According to WHO data, obesity among children under 5 years old has approximately tripled since 1975, and the number of overweight or obese children and adolescents aged 5-19 years now exceeds 340 million (2). This increase suggests that paediatric MetS may become more prevalent due to the established association between obesity and metabolic disorders. Many factors play a role in the pathogenesis of paediatric MetS. Increased visceral adipose tissue initiates biochemical chains resulting in systemic inflammation and insulin resistance (IR), which in turn leads to the emergence of components including impaired glucose metabolism, atherogenic dyslipidaemia and hypertension (7).Along with genetic predisposition, environmental factors such as unhealthy diet, physical inactivity, sleep disorders and micronutrient deficiencies accelerate these processes. These complex interactions show that MetS is not only a collection of findings but also a systemic and progressive disorder.MetS detected in childhood is often not a transient condition, and the possibility of being carried into adulthood is quite high. This continuity feature is defined as "tracking phenomenon" in the literature and emphasises that metabolic irregularities starting at an early age may lead to serious health problems in the future (2). As a matter of fact, MetS initiated in childhood paves the way for early cardiovascular diseases, type 2 diabetes, non-alcoholic fatty liver disease (NAFLD) and other endocrine-metabolic disorders in adulthood. In addition, psychosocial problems accompanying obesity and metabolic disorders, such as low self-esteem, depression, social exclusion, significantly reduce the quality of life of the child and adversely affect the course of the disease.This book aims to provide a comprehensive approach to understanding the multidimensional nature of MetS in childhood. By presenting a wide range of information from pathophysiology to epidemiology, from clinical features to diagnostic criteria, from treatment and follow-up approaches to prevention strategies; it is aimed to provide a scientific and up-to-date reference source for health professionals and researchers.